Individual provider · Type 1 NPI

Kusumo Sumardi, DDS

General Practice Dentistry · La Verne, CA

NPI number 1811037435 Active

Practice location

1965 Foothill Blvd, Suite L
La Verne, CA 91750-3502

Call (909) 596-6500 Map

Fax (909) 596-8809

Mailing address

3870 Grand Ave
Claremont, CA 91711-1454

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X41680 (CA)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1811037435

Kusumo Sumardi, DDS's National Provider Identifier is 1811037435, issued on Feb 6, 2007. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in La Verne, CA. The record was last updated on Jul 8, 2007.